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The growth signal is therefore indirect and paracrine : activating those receptors releases IGF-1, IGF-2, keratinocyte growth factor and nitric oxide , and those mediators drive crypt-cell proliferation, increased villus height, deeper crypts and increased intestinal and portal blood flow [1] [5]

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Pemphigus and bullous skin reactions (bullous rash), including erythema multiforme, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), have been reported during postmarketing experience with topiramate